What Is Improvement Science?

The Concept

The concept of improvement science recently emerged to provide a framework for research focused on healthcare improvement. The primary goal of this scientific field is to determine which improvement strategies work as we strive to assure effective and safe patient care.

The conceptual framework that guides the Improvement Science Research Network (ISRN), includes all aspects of research that investigates improvement strategies in healthcare, systems, safety, and policy. The science of improvement is a nascent field, emerging along with other fields to answer the call of the IOM Report to improve healthcare quality and safety. Improvement science is a new field of science. As the science of improvement evolves, the conceptual relationships of organizational systems relevant to IS will be tested, and terminology that is now used in different ways across the new sciences will emerge and be more precisely demarcated and will drive the science forward. The phrase, “Improvement Science” is often compared with other sciences, such as translational science and implementation science, evidence-based practice, knowledge translation, and research utilization. Although there are some similarities across these fields, the conceptual frame of reference for IS allows a broad scope of scientific study about which improvement strategies work best in the complex adaptive system of the acute care organizational system in different ways.

The ISRN will contribute to the development of a working definition of the term improvement science.

State Of Improvement Science

Quality improvement and patient safety are imperative clinical targets supported by policy, patient advocacy, and healthcare professional groups, yet research to determine which improvement strategies are effective has been insufficient at best. While the need for this research evidence is high, corresponding capacity among health scientists to conduct rigorous,
well-designed, and action-oriented studies is lacking.

This gap is caused in part by the rapid evolution, or lack of research approaches in the field of improvement science. In particular, the theories, methods, and designs for achieving rigorous research in the field are
newly-arising and many healthcare scientists are not yet skilled in applying these new research methods. Some research approaches have yet to be formulated. Education and training programs are only beginning to include these topics in the education of future healthcare scientists.

Attempts to achieve optimal care have been expressed via a wide array of approaches, including translational research targets, evidence-based care, accreditation and external accountability for quality and safety, risk management, error prevention, organizational development, leadership and frontline enhancement, and complex adaptive systems frameworks (Grol, et al, 2004). Nevertheless, most improvement strategies are insufficiently evaluated. Well-designed investigations and sufficient sample sizes are required to understand cause-and-effect and produce robust improvement science.

Goal Of Improvement Science

The overriding goal of improvement science is to ensure that quality improvement efforts are based as much on evidence as the best practices they seek to implement (Shojania & Grimshaw, 2005). Simply put, strategies for implementing evidence-based quality improvement need an evidence base of their own.